- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.22 / $8.07 / $9.16
| Facility | | $6.22 | $8.07 | $9.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.22 / $8.18 / $10.91
| Professional | | $6.22 | $8.18 | $10.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.96 / $13.78 / $34.81
| Facility | | $7.96 | $13.78 | $34.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.66 / $6.66 / $6.66
| Professional | | $6.66 | $6.66 | $6.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $8.00 / $12.46
| Facility | | $5.50 | $8.00 | $12.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.46 / $12.46 / $12.46
| Facility | | $12.46 | $12.46 | $12.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.85 / $5.85 / $6.03
| Facility | | $5.85 | $5.85 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.97 / $5.08 / $5.85
| Professional | | $4.97 | $5.08 | $5.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.68 / $61.68 / $93.45
| Professional | | $61.68 | $61.68 | $93.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.41 / $9.35 / $12.46
| Facility | | $3.41 | $9.35 | $12.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.21 / $11.21 / $12.46
| Professional | | $4.21 | $11.21 | $12.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.41 / $8.91 / $12.46
| Facility | | $3.41 | $8.91 | $12.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.97 / $5.08 / $8.81
| Professional | | $4.97 | $5.08 | $8.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $5.74 / $7.57
| Professional | | $4.37 | $5.74 | $7.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.35 / $5.35 / $12.46
| Professional | | $5.35 | $5.35 | $12.46 |